Primary sternal tuberculosis: a case report and review of the literature

Abstract

Introduction: Primary sternal osteomyelitis caused by Mycobacterium tuberculosis is a rare manifestation of extrapulmonary tuberculosis. Case presentation: We present a case of isolated sternal tuberculosis and review the demographic, clinical, diagnostic and therapeutic features of 32 published cases found in a systematic review of the literature. Patients with primary sternal osteomyelitis due to M. tuberculosis are often young and have no co-morbidity. Diagnosis is frequently delayed. Common symptoms and signs are local swelling and a discharging sinus tract. Patients frequently have at least one systemic symptom, including fever, weight loss and night sweats. Our case and half of those found in the literature review were successfully treated with antituberculous drugs alone. Conclusion: Treatment concepts for primary sternal tuberculosis are not established and are often derived from those of osteoarticular tuberculosis. These data point towards an interdisciplinary concept without surgery.

A Rare Case of Rifampicin Resistant Primary Sternal Tuberculosis Along with Miliary Tuberculosis of Lung

“…reviewed 27 articles reporting 32 cases from 1966 to 2013 and found that Primary Sternal tuberculosis was more common in men and occurred at a young age. [18] The reactivation of latent foci formed during hematogenous or lymphatic dissemination of primary TB is the primary cause of tubercular sternal osteomyelitis. Direct extension from contiguous mediastinal lymph nodes or infection of retro-sternal lymph nodes that erode into the sternum over time are other mechanisms.…”

Imaging diagnosis of sternal tuberculosis- A report of two cases of the ancient disease with a new demeanour

“…Even amongst the skeletal structures, sternal involvement accounts for only 1-2% of all bone and joint tuberculosis [7 , 8] . Most of the reported cases of this rare entity, are in adult patients and very few in children [5 , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] . We report two cases of sternal tuberculosis both in immunocompetent patients, the first in a 7 year old child and the second in an adult male.…”